| NPI | 1952294175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE HENNESSY Ap RN 352-351-8077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-08-05 |